Topic

Pennsylvania

A collection of 502 issues

Complete Guide: Getting Imbruvica (ibrutinib) Covered by UnitedHealthcare in Pennsylvania - Prior Authorization, Appeals, and Success Strategies

Answer Box: Your Path to Imbruvica Coverage in Pennsylvania Getting Imbruvica (ibrutinib) covered by UnitedHealthcare in Pennsylvania requires prior authorization, proper diagnosis documentation, and often step therapy compliance. Most approvals take 5-15 business days with complete submissions. If denied, Pennsylvania's new external review program has overturned 50% of
6 min read

UnitedHealthcare's Coverage Criteria for Gattex (Teduglutide) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Gattex Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Gattex (teduglutide) with strict medical necessity criteria: documented short bowel syndrome, 12+ months of parenteral nutrition dependence (≥3 days/week), failed enteral optimization attempts, and recent colonoscopy with polyp removal. Fastest path to approval: Submit complete
6 min read

How to Get Bavencio (Avelumab) Covered by Humana in Pennsylvania: Complete Prior Authorization Guide

Answer Box: Getting Bavencio Covered by Humana in Pennsylvania Bavencio (avelumab) requires prior authorization from Humana for both Medicare Advantage and commercial plans in Pennsylvania. For fastest approval: (1) Confirm your diagnosis meets FDA indications (metastatic Merkel cell carcinoma or maintenance urothelial carcinoma), (2) Have your oncologist submit PA through
6 min read

How to Get Rylaze Approved by Cigna in Pennsylvania: Prior Authorization Forms, Appeal Process, and Medical Necessity Requirements

Answer Box: Getting Rylaze Covered by Cigna in Pennsylvania Rylaze (asparaginase erwinia chrysanthemi [recombinant]-rywn) requires prior authorization from Cigna in Pennsylvania. The fastest path to approval: submit Cigna's Rylaze PA form with documented E. coli asparaginase hypersensitivity, ALL/LBL diagnosis, and oncologist prescription. Standard approval takes 72
5 min read